HomeMy WebLinkAbout1206-0265 APPLICATION FOR ROOF PERMITSCANNED -
BY
DATE:J_ � FEES DUE: 1 in I RECEIPT #: <3 % _ / 1,1J I YPrmlr #1
1. Location/Site Address:
I GL(o 'UoI-� 5
Planning & Development Services Department
Building & Code Regulation Division
2300 Virginia Avenue
Ft. Pierce, FL 34982-5652
Tel. 772-462-1553
APPLICATION FOR ROOF PERMIT
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5 EREVE E,n c SI�E FORCyr INST CTIONS
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2. Parcel ID Number: 1312 —500 - 0 // / —
Office Use
Section
I Township
Range
Map Page
zonin
Land Use
I f itials
Only1�2
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3. Description of Projector Work Activity:
4. Total Roof Area (square feet): 31o0 d 5. Roof Pitch: Z
6. Type of Roof: [X Fiberglass Shingle f ] Concrete Roof Tile [ ] Wood Shake / Shingle
[ ] Tar & Gravel [ ] Modified Bitumen [ ] Other
[ ] Product Approval required for all types of Roofing Material (2 Sets)
] All Commercial Roofing requires design by an Engineer or Architect (2 Sets) with Product
Approval attached
* * Roof Mitigation per F.S. 553.844 will be required.
7. Owner Information 8. Contractor Information
Name: oLal!:g are-1 67rfh2rk 'n
Address:
�s�to� its ecA' plheS, G'�6e
P City: . AetcP State: FL
Zip: 3 tfe� / Phone: ?72
9. Value of Construction: $ 1 &'r-g,
FL Reg/Cert #: (�C j!)!�90a
County Cert #: AO2 b
Business Name: t 2 °tO 144,
Cell Phone: Z72-
a*Note Dry -in and Final Inspection Required. Additional inspection may be required per Product Approval.
CONTRACTOR/OWNER'S AFFIDAVIT: I certify that all of the information contained m this application is correct and that all work will be
N done in compliance with all applicable laws regulating construction and zoning.
OF QUALIFIER/OWNER
STATE OF FLORIDA, COUNTY OF 9-, L1I .C4XJ pp
ACKNOWLEDGED BEFORE ME THIS 8b DAY OF L,�,_— 20 Z, BY 1 da„� JB �A-KK
O IS PERSONAWY WN VTC ME OR HAS PRODUCED AS IDENTIFICATION
K)a AX, , ` l j 'o� o Naney L Hamilton
S NATU O NOTARY rL TYPE OR P I T NAME OF NOTARY (s�{}r %0oMMIS510N #EE035845
D� ��,o ! OCT. 19, 20Y4
COMMISSION NUMBER �, WWW.AARONNOTARYcom
NOTICE TO OWNER: FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE
FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT YOUR LENDER OR
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT.
Revised 4/26/2010